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Everyone knows that moodiness in women is often blamed on hormones. Did you know that similar hormone imbalances can occur in men, making them ill tempered and cranky?

“Mood swings in men are primarily a symptom of andropause, a hormone imbalance in men that usually occurs between the ages of 40 and 60,” explains Richard Giannotto, MD, a metabolic wellness physician in McLean, Va. This “irritable male syndrome,” as it’s often referred to, is the result of low levels of testosterone (low T) and high levels of the stress hormone cortisol, Giannotto says. “Resulting behaviors include anger, sarcasm, frustration, sadness, depression, being withdrawn, hostile, and/or anxious, and dissatisfaction,” adds Giannotto. Low energy can also be a problem with low T, as well as low desire.

Low testosterone in men can also mimic symptoms of low T and menopause in women. “I have some patients with low T who describe hot flashes, night sweats, and changing sleep patterns, which then result in sleep deprivation and more irritability,” says Damon Raskin, MD, a physician practicing internal medicine in Pacific Palisades, Calif.

No matter what the specific symptoms, Dr. Raskin says low testosterone in men is under-diagnosed. In fact, an estimated 13 million American men suffer from low testosterone, and 90 percent go untreated. “I see it all the time -- men come in and tell me they’re depressed, and they haven’t considered that their depression may be a symptom of low testosterone,” he says. “And in some cases, doctors themselves don’t consider low testosterone, and they treat the depression itself. But some studies show that up to one third of men who walk into primary care offices may have low testosterone, especially men over 40.”

In some men, low testosterone has no specific cause. In others, there are physiological reasons for hormone imbalances. Those reasons may include the following:

Increasing age. “As men age, they begin to produce less testosterone and more cortisol, and by the time they reach age 50, they notice weight gain, low energy, decreased libido, and mood changes,” Giannotto says. “This constellation of changes is referred to as andropause.”

Benign tumor. “A benign tumor in the pituitary gland can cause low testosterone, so this is something a physician may look for and rule out if they find low T,” Raskin says.

Certain medications. “There are certain drugs, specifically opiate pain killers, that can cause low testosterone,” Raskin says. “So when we see hormone imbalance in men who are younger, it may because they are abusing opiates.”

On the Lookout for Low Testosterone Symptoms

Because low testosterone can affect your mood so significantly, the condition can affect family members, too. “Some men with low testosterone can appear to be unloving,” Giannotto says. Low T may not just affect you emotionally and physically, but can also affect your relationships with family members and friends.

The first step in getting low testosterone under control is to recognize the symptoms, such as low energy, depression, and irritability.

“A lot of men think their symptoms are a normal part of aging. They think, ‘I don’t want to have sex as often as usual, and I have low energy simply because I’m 50.’ Men need to listen to their bodies and recognize their symptoms as unusual,” Raskin says.

Second, if you think you have symptoms of low T, see your doctor. “A lot of men, just by being men, don’t go to the doctor for anything,” Raskin says. “But in order to know for sure he has low testosterone, a man must be screened at the doctor’s office.” Raskin adds that the best time of the day for testosterone screening is in the morning. “You don’t have to have a fasting blood test, but a morning blood test will be a better test. In addition, be screened for possible secondary causes of low T or depression, including a pituitary tumor or other hormonal imbalances.”

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